Modified abdominal organ cluster transplantation refers to the transplantation of abdominal organs including the stomach, pancreas, duodenum and small intestine in a series of organ clusters in addition to the liver.

Therefore, everyone's enthusiasm for observation is very high, and the general surgery department is pouring out of the nest today, and doctors from other departments have come to visit the door, after all, this kind of surgery with extremely high technical content is usually rare.

"Xiao Chen, show that the classroom is live broadcasting, is the picture clear?" Director Fang asked Dr. Chen in the audience.

Dr. Chen is a graduate student of Director Fang, and he is one of the few doctors who are allowed to observe in the operating room, but he is responsible for the maintenance of the live broadcast of the classroom, so he also runs at both ends.

"It's very clear, it's being broadcast, the scene is very hot, everyone stretches their necks and stares at the picture, saying that the level of the main knife is high." Dr. Chan did not forget to compliment his mentor.

Director Fang smiled: "Yes, you stare at the point, if there is any problem with the video, go directly to the computer department on duty, you're welcome, get some supper or something for everyone, don't just sit down, I'll treat you." ”

The classroom is not a sterile area, just like the rest room and dining room of the operating room, you can take off your mask and eat.

Dr. Chen immediately took the order to go out to Zhang Luo, and the mentor was happy today, and Dr. Chen was still wondering if there was anything difficult for him to ask for the mentor's help, so he simply waited for the next time to bring it up.

Director Fang continued the operation, Pan Doudou's broken organs are indeed very difficult to remove, no wonder Director Luo didn't cut anything off for a long time, due to the influence of chronic inflammation, there are adhesions everywhere, blurred everywhere, and the anatomical structure is not clear at all.

If it weren't for Yang Ping guiding Director Fang like this, Director Fang would have done it himself.

The steps of allogeneic organ transplantation are actually three steps, the removal of the donor organ, the removal of the patient's organ, and the transplantation of the allogeneic organ.

The first of these three steps has been successfully completed, and the donor's pancreatic, gastroduodenal and small intestine have been successfully removed, and now they are soaked in a special liquid and stored for transplantation.

At present, Director Fang is in the second step, and the removal of any organ in the human body is to cut off various connections between the organ and the human body, such as blood vessels, nerves, mesangium and other structures.

The most common type of organ removal is amputation, and in the old era of barbaric medicine, the mortality rate of amputation was extremely high, because the amputation at that time was almost a horror movie, using a knife or saw to amputate the patient, and then pressing the stump of the amputation directly into a boiling oil pot or boiling water, which was thought to kill the bacteria.

So at that time, amputation was simply the most terrifying and painful operation, and after such a horrific surgical process, many patients after amputation died of infection.

Now amputation is different, under anesthesia, disinfection and spreading, and then the connection between the waste limb and the human body-—— blood vessels, nerves, ligaments and muscle tendons are all broken, and the blood vessels have to be ligated.

Anesthesia, hemostasis, and aseptic surgery are the three cornerstones of surgery, and it has only been since their advent that modern surgery has begun.

In fact, in ancient times before the advent of modern surgery, traditional Chinese medicine was not only mild compared to European medicine, but more importantly, it was far ahead of European medicine in terms of theory and therapeutic effect, and it was not even a dimension.

Director Fang's surgical steps are very clear, pleasing to the eye, not fast or slow, in short, the operation is stable, after all, Director Fang is passively following Yang Ping's guidance, so it is definitely impossible to say that it is very fast, but at present, this speed is rarely matched.

The excision of the pancreaticoduodenum is considered to be a difficult operation in general surgery because of the large number of blood vessels that supply blood and the complex step-by-step process, and the vascular nerves are the target that must be seriously faced in any operation.

The pancreas is divided into the head of the pancreas, the body of the pancreas, and the tail of the pancreas, and the blood vessels supplying the head of the pancreas are the superior and inferior pancreaticoduodenal arteries that are anastomostomosed with each other, while the superior pancreaticoduodenal artery comes from the gastroduodenal artery, and the inferior pancreaticoduodenal artery comes from the superior mesenteric artery.

In addition to the splenic artery, there are dorsal pancreatic artery and transverse pancreatic artery from the celiac artery, and branches of the splenic artery, the major pancreatic artery and the caudal pancreatic artery.

In addition to the arterial blood vessels, each organ also has a reflux vein, and the pancreatic veins eventually join the splenic vein, superior mesenteric vein, and portal vein.

The duodenum is a part of the small intestine, and its blood supply vessels are mainly the superior anterior pancreaticoduodenal artery, the superior posterior pancreaticoduodenal artery and the inferior pancreaticoduodenal artery, while the blood supply of the entire small intestine is mainly the superior and inferior mesenteric artery.

The pancreas connects the duodenum through the pancreatic duct, and the pancreatic duct opens in the inner wall of the duodenum to inject the pancreatic juice produced by the pancreas into the duodenum, and the main role of pancreatic juice is to digest and decompose fat, so the pancreas should not only deal with the blood vessels, but also deal with the pancreatic duct.

The arteries of the stomach are mainly the left gastric artery, the left hepatic artery and the splenic artery.

With so many blood vessels densely distributed, and some of them kissing each other in a ring, the lines are extremely complex, which is why the pancreaticoduodenum can be removed smoothly, marking the highest step in general surgery.

In the face of these complex blood vessels, Director Fang sat firmly on the Diaoyutai platform, unhurried, and focused on following Yang Ping's rhythm.

Soon, the blood vessels, nerves and mesangium of the pancreas, stomach, duodenum and small intestine were cut off one by one by Director Fang, and the entire organ cluster was detached and successfully cut off.

The second step is completed, and now the third step is to transplant the donor's organ to Pan Doudou, the most critical step of organ transplantation is the anastomosis of blood vessels, restore the normal blood supply, and let it survive is the king.

The blood vessels in the abdominal viscera are relatively thick, unlike the blood vessels that need to be anastomosed for finger replantation and coronary artery bypass, and if it is a coronary artery bypass with a non-stop heartbeat, the heartbeat will also interfere with the surgical operation, and the current abdominal organ cluster transplantation does not have these problems.

For this operation, Director Fang also made full preparations in advance, Cheerilee didn't know how many boxes he bought for the doctors and nurses of the Institute of Surgery, so that he could train vascular anastomosis in the training room, and later practiced with the pigs in the experimental building a few times, so there was still goods in the stomach, otherwise Yang Ping would not be able to hold it.

The most difficult thing about abdominal organ cluster transplantation is not the pancreas, but the small intestine transplantation, because the small intestine is a high immune organ, containing a large number of lymph nodes, which is very prone to rejection, and the small intestine is rich in various intestinal bacteria, which is very easy to cause infection, so the operation is very difficult and the risk is very high, otherwise today's surgery would not attract so many people.

In fact, any allogeneic organ transplant will face the problem of rejection, but the degree is different, allogeneic organ transplantation requires anti-rejection therapy, and anti-rejection drugs often cause hyperlipidemia, hypertension, high uric acid, and may also cause bone marrow transplantation, cause leukopenia and thrombocytopenia, inhibit the patient's immunity, and lead to infection, but these complications are insignificant compared to saving lives.

Combined pancreaticoduodenectomy is a major surgery and a landmark operation in general surgery, while the incision and transplantation of pancreas, stomach and duodenum are more difficult.

When the blood vessels were anastomized, Director Fang was more worried, because at this time, as the chief surgeon, he had to do a lot of complicated operations independently, and Yang Ping's help as an assistant was very limited, and he could only help fix the blood vessels, and he couldn't help too much.

Director Fang calmed down and cheered himself up, and it was not a broken finger replantation, nor was it a coronary artery bypass, what were you afraid of, such a thick blood vessel was still afraid of a ball.

In fact, Director Fang was not afraid that he would not be able to handle the gentle blood vessels, but that he was worried that the contrast between the front and back of the operation would be too great, which would seriously affect his image tonight.

After all, tonight in front of everyone, he is a person who has done a smooth transplant of abdominal organ clusters, and if he looks very lame when he waits for the anastomosis of the blood vessels, it will not be very shameless.

Yang Ping saw that Director Fang was a little lacking in confidence, so he used fine toothless forceps to clamp the adventitia of the vascular mouth, gently lifted the blood vessel, and sent it to Director Fang to trim the adventitia of the blood vessel.

The blood vessels mentioned by Yang Ping make it very convenient for Director Fang to trim the adventitia, because this angle is the best angle, and Director Fang can complete the trimming of the adventitia in the most comfortable and natural posture. Moreover, Director Fang's microscopic scissors had just cut open the outer membrane that had just been lifted, and another toothless tweezer in Yang Ping's hand had already lifted a new outer membrane and sent it to his scissors.

Seeing the cutting of a circle of outer membrane, Director Fang himself couldn't believe how his craftsmanship was so good.

The outer membrane of the two broken ends of the donor organ and the patient's blood vessel have been built, Director Fang began to anastomoses the blood vessels, and the anastomosis blood vessels are much easier than he imagined, just like trimming the outer membrane, Yang Ping lifted the broken end of the blood vessel and posed it at the best angle, so that Director Fang only needs to enter and exit the needle from a natural point of view, and there is no need to worry about anything, even if the angle of the needle is not good, Yang Ping will make adaptive adjustments to the broken end of the blood vessel, and directly cater to Director Fang's stitches, not the needle to find the blood vessels, but the blood vessels to find the needle, and the needle becomes the passive party. The blood vessels become the active party.

In an instant, Director Fang completed the stitching of a stitch, and the movements were standard and smooth, with almost no pressure.

The chief surgeon and the assistant came and went, and the cooperation was perfect, and the doctors who observed the operation saw this kind of suture with a strong sense of rhythm, and they all admired Director Fang's great progress.

In fact, this is like playing table tennis, each ball of the opponent is sent to your most comfortable receiving position, the height is impeccable, you just need to stand still, gently reach out to block, and the ball passes.

After a few back and forth, Director Fang's confidence immediately increased, he could still operate like this, he was very smart, and immediately saw Yang Ping's feeding routine, so he took the initiative to suture it himself, and those who were not so good at suturing simply put the needle in a good posture, and let Yang Ping take the blood vessel to find the needle.

According to this model, with the cooperation of Yang Ping, Director Fang continued to suture the blood vessels, and the more he went to the back, the more Director Fang found the rhythm.

The pancreas, stomach, duodenum and small intestine have dozens of blood supply vessels, large and small, and it is also a big project to suture them.

Now it seems that with Professor Yang on the other side, he can't drop the chain, so Director Fang decided to step on Professor Yang's rhythm and stride towards the peak of academics.

Not to mention blood vessels, even the reconstruction of the pancreatic duct, Director Fang is stable.

The same is true for the suturing of some nerves, and with the help of Yang Ping, it also seems very easy.

On the side of the classroom, it was very lively at this time, and Dr. Chen ordered a lot of takeout supper according to the instructions of the instructor, and everyone felt very comfortable while eating supper while observing the operation.

These general surgeons, seeing the smooth operation on the screen, the young doctors bowed to the other director, why is the director so awesome today, and the abdominal organ cluster transplantation is so smooth, it seems that there is no chance to play in ordinary times, and today can be regarded as giving full play to their surgical level. The more directors with several high-ranking titles look at it, the more wrong it becomes, and there is a bit of a problem with how to look at this operation, which is not the same as how they usually feel about the operation, but they can't say what the problem is.

It's like watching other people play table tennis, only knowing that you come and I are inseparable from each other, and I feel that there is a problem in it, but I can't say it for a while.

Oh! Several directors finally saw the secret, this assistant is too active, sometimes the assistant takes the blood vessel to the thimble, so it sees, this is Professor Yang is performing a large feeding technique.

A few doctors with high professional titles took a closer look, and now they can see it clearly, it is indeed the case, with the full cooperation of Professor Yang, Director Fang is now sweating profusely. This is the same as Dean Xia's basketball game, the annual hospital basketball game, Dean Xia is extremely powerful, always able to score in the army, and frequently win the applause of the audience, even if a strong man like Xiong Sihai in the emergency department can't stop Dean Xia's three-step layup, because at this time Xiong Sihai seems to be strictly guarding Dean Xia, but it is always a little bit worse, so that Dean Xia frequently breaks through, and the ghost is that Dean Xia can always get the ball in the best scoring position, and the opponent at this time will always be a little bit worse. It wasn't until Professor Zhang Zongshun served as the chief referee that the myth of Dean Xia was extinguished, Dean Xia didn't score a few points in the whole game, and he was almost sent off, and the best player and scoring champion of Dean Xia every year was also forced to change hands.

Until now, as long as Dean Xia sees Professor Zhang Zongshun playing basketball, his legs tremble and the ball is unstable.

Looking at Director Fang's surgery today, how similar it is, it's like opening your mouth with a meal and hitting it directly into your mouth.

PS: I have a cold today, I don't have a manuscript, I can only send so much, thank you!